TRANSMITTAL of OMAHA LEAD SITE 

SOIL REMEDIATION FILE FOLDER 

SAID#: (.^liqC> Date: K 10^ A l 

Address: i^ % \\ H^ ^ ift/f^ 

Remediation Contractor: Coastal Environmental Group_ Year: _200B 

SOIL REMEDIATION 

PROPERTY FILE FOLDER DOCUMENTS 

/ 

Video of property (DVD) 

Executive Summary 

EPA-provided property sketch 

0 Signed Access Agreement for subject property 

W ^ Signed Access Agreement(s) for adjacent property 

E Z Restoration Agreement 

-0" Settlement documents (i.e., for damage or to replace plants, etc.) 

-& Confirmation data 

B ^ Photographs fH-(rycCPc/filio^. bcCfi(Vfr(U^ \ V ! ^ Un, 

E As-built sketch 

0^ Satisfactory restoration signed by Property Owner 

IZ Property close-out check list signed by EPA 

"t P Description ofareas not meeting ROD cleanup criteria 

0 Utility clearances 

(2f Property information from Douglas Coimty Assessor's Office 

D 

• 

D 

Signature 

30054435 

Superfund 
m 

CONTACT FORM 

Property ID # tp'^4^^ 

Property 

Address: IMZ ^ 1M Mf^ AV 

Initial Contact: Date: Time: Action: 

Second Contact: Date: Time: Action: 

Final Contact: Date; Time: Action: 

Final Action: Transmit to EPA D Other Action: D 

Comment: 

Owner 

Comment (s): 

Site 

Coordinator 

Comment (s): 
_ _ 

Property Access Checklist 

PropcrnlD: [(^'^U^I D 

D WORK STARTED ON: / / 

Propert D WORK COMPELTED ON: y Add re»:2l4:2,(^ VlU'^-Wv/^ V 

Renter 

Addres AH.Ir<.<c- ^s 

Phone: 

F«LV: 

Cell/Pager: 

Phone Additional Inlnrmxtion: : /'uoz) ;^2g-^/^ 1 \Mort 

ccm^.g.r{L{Q2) 0\U)^-^Q2" 

D Notification Letter Sem: 

Bv: 

Acceu' AprccmCDt 

Sipicd:\j_/Jiy/C3 ^^'-VfecAtiPj- Vir)v^VK;l'ngj 

Reslonttion Agreement Signed: lL/ii(?/Q^ By^qp/rAl^ UflvgVt^biiA^x • Topsoil Sampling (if applicublt) 

D Disposal Sampling (K upplictble) B j : 

D Gnrdcn Snmpliag (if applicable) By: 

D Utility Clearance Called: By: 

© • Video/Photos (Before) 

On:_it_/2k'.^ ^y- Srfftva /flcW\o • Video/Pholos (During) OD: Bv: 

D Video/Pholos (After) On: By: 

D Video/Pholos (30-Dny) O D : By: 

O Property Complelion Agreemenl Signed: / /_ By: 

D Final Report Issued: By: 

Air MoniiorinK {nn applicable 

D Community d Crcw O D : / / By: 

RcsuJts: 

D ComrounltA' D Crcw On: / / By: 

Remits: 

D CommunitA D Cn:\y On: / / Bv: 

ResulU: 

Omaha Lead Site 

' V 
• Douglas Coimty Account In||^^tio i||^ t n Page 1 of2 

Douglas County, Nebraska Property Record - R0811330000 

Print Report 

NEW Feature - Parcel Dimensions available @ scale 0-50 ft west of 52nd St - Vie w o n Ma p Infonnation is valid as of 2009-5-12 Treasurer's Tax Report 

New Feature ^ •• •• Auto Sales Search 

Owner 

HOUGHTALING HEATHER D 

ETAL 

2436 N 45 AVE 

OMAHA NE 68104-0000 

Property Informatio n 

Key Number: 1133 0000 08 

Account Type: Residential 

Parcel Number: 0811330000 


Parcel Address: 2436 N 45 AV 

OMAHA NE 68104-0000 

Legal Description: CUiklRMONT LOT 11 BLOCK 3 50 X 125 

Value Informatio n 

Land Improvement Total 

2009 $6,400.00 $101,900.00 $108,300.00 

2008 $6,400.00 $101,900.00 $108,300.00 

2007 $6,400.00 $101,900.00 $108,300.00 

2006 $6,400.00 $101,900.00 $108,300.00 

2005 $6,400.00 $70,400.00 $76,800.00 

2004 $6,400.00 $64,000.00 $70,400.00 

Land Informatio n 

Acres SF Units Depth Widtii Vacant 

0.14 6250.0 1.0 125.0 50.0 No 

Improvemen t Informatio n 

Building 1 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accoimtno=R081... 6/7/2009 
1

1 

Douglas County Account I i^^^ i ition Page 2 of2 

M a t N « AV 

lA .^^ ^ 

11D 

^ ^ ^ 

m nsn t 

^^H QI^HI • H » « « >* * H MM>*M* CLICK TO ENLARGE IMAGE 

Square Footage: 2446.0 

Perimeter 0.0 

Unit Type: End 

Built As: 2 1/2 Story Unfin 

HVAC: Central Air to Air 

Exterior: Frame Vinyl 

Interior: Drywall 

Roof Cover: Composition Shingle 

Roof Type: Hip 

Floorcover: Allowance 

Year Percent Year Built Remodeled Remodeled 

1918 0 0% 

Detail Type Detail Description 

Add On Fence Chain Link 

Appliance Allowance 

Appliance Fireplace Masonry 

Basement Bsmnt Block 8 ft 

Fixture Additional Fixtures 

Fixture Base Fixtures 

Fixture Bath Full 

Garage Detached 

Porch Slab Roof Ceil 

DO «) « 

FlratFtoor 

iSMOtq « Swood Fkiar 

1148 Oiq*. 

I I 

KC K t 

SMiRDtfCH 

DO 

..... ae 

ISEC'H) R 

CLICK TO ENLARGE IMAGE | 

Percent Complete: 100.0% 

Quality: Average 

Condition: Average 

Condo Square Footage: 0.0 

Rooms: 10.0 

Units: 2.0 

Batlis: 3.0 

Bedrooms: 3.0 

Stories: 2.0 

Foundation: Block 

Sprinkler Square Footage: 0.0 

Adjusted Year Physical Age Built 

1918 91 

Units 

1.0 

1.0 

1.0 

1288.0 

1.0 

1.0 

3.0 

720.0 

224.0 

http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R081... 6/7/2009 
Page 1 of 1 

Create Another Ticket Back to Irth Intemet [ Send Email ] ][ 

YOUR TICKET NUMBER IS 2326027. 

Original Call Date: 7/24/09 Time: 5:48 pm Op: ELIZABETH18790 

Work to Begin Date: 7/28/09 Time: 6:15 pm 

State: NE County: DOUGLAS Place: OMAHA 

Address: 2436 Street: N 45TH AVE 

Twp: 15N Rng: 13E Sect-Qtr: 08-SW 

Twp: Rng: Sect-Qtr: 

Legal Given: C 


Type of Work: lead remediation 


Location of Work: INCLUDE ALL EASEMENTS LOCATE ENTIRE PROPERTY 


Remarks: FAX ALL CLEARS TO: (877)662-4211 


: UNSURE OF CORNER LOT. 


Company : COASTAL ENVIRONMENTAL SERVICE 


Contact Name: ELIZABETH Phone: (877)662-4210 


Work Being Done For: coastal 


Depth of Excavation: 4ft Corner Lot: N Front: Y Rear: 


Involves Tunneling or Horizontal Boring : N Explosives: N 


CXCATV MUDOl OMAHACOF 0PPDGPR5 QLNNEIC 


Service Area Contact Phone Number Utility Type 

Day: 4029340469 

CXCATV COX COMMUNICATIONS, INC HEIDI Alt: 4029340469 

Emerg: 4029329757 

Day: 4025047823 

MUDOl METROPOLITAN UTILITIES DISTRICT SANDY Alt: 

Emerg: 4025047970 

Day: 4024447197 

OMAHACOF CITY OF OMAHA-TRAFFICSEWER RON Alt: 4024445161 

Emerg: 4024445160 

Day: 4067289343 

OPPDGPR5 OMAHA PUBLIC POWER DISTRICT NA Alt: 4062071494 

Emerg: 8887289343 

Day: 4067289343 

QLNNEIC QWEST LOCAL NETWORK NA Alt: 4062071494 

Emerg: 8887289343 

http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS... 7/24/2009 
As-Built Drawing 

COASTA L Omaha Lead Superfund Site 

63496 

Exterior Paint Morth Arro w Omaha Lead Site 

Site Sketch 

• Poor 

Sampling Address: 2436 N 45 , r~1 Not paint 

Sample Number Lead 

Concentration 

Sample 

Collected LAB 

Firm; 

Samples Collected 

PC C.C . E - K: . 

RYASCPXA-63496 Fl Li i ppm D Date yO - 2.7 - O SiRYBSCPXA-63496 F2 ppm a Time; 1 O •. .b -i p. 1 ^ . 

nVCOOrXA 63406 

RYDSCPXA-63496 

Bl 

B2 11 ^. ^ 

ppm 

ppm 

n n 

n Samples Analyzed 

RDZSCPXA-63496 DZ ppm n XRF Unit AJ5«V 0 Book: 2.2J O 

nOZOGrXA-63406 

RP2SCPXA-63496 

GZ 

PZ .7 3 

ppm 

ppm 

Number of Samples = | 5 \ I 

D 

n 

Date; 

Time; 

Staff; _ 

tl O'S 0 & 

A. ^ 

m-^u? 

Legend: Fl = Front Left. F2 = Front Right, Bl = Back Left. B2 = Back Right DZ = Drip Zone, GZ Garden. PZ = Pla' 

All quadrants are as viewed from the street, facing propefty OLS#: 63496 

Date Excavated :7/30/09 

Date USEPA Signed Off: 8/11/09 

Legend 


^ \'\' Concrete Drip Zone Excavated • ; < 

Quadrants Excavated 

Area replaced with Area replaced with 

Area left bare 
 Sod Rock/Mulch 


Contract #: EP-R7-07-05 Coastal Environmental Group Inc. 

•>« K s 

yVwUivl* 
V ­

63496 

E)rterior Paint North Arrow J \Ji Z i (^ ^ w Omalfa Lo Lea d Site

g^oo d tr> ^\ ^ Sitee Ske Sketci h • Poor 

Sampling Address: 2436 N 45 AV Q Not paint 

Sample Number Lead Sample Samples Collecied LAB Concentration Collected Firm: y£' Cc . EK . 

RYASCPXA-63496 F1 __L2Ji_ ppm D 

Date: | 0 -Z7-OSr 

RYBSCPXA-63496 F2 22-7 ppm 0' D Time: IO'. S'l (^ f ^ 

RYCOCnXA 63406 h\ - ppm D D Samples Analyzed RYDSCPXA-63496 B2 ppm a in3 RDZSCPXA-63496 DZ ppm n XRF Unit: Ce5'-l0 Book: ZZ O 

nOZ0CrXA-C340G S2- ppm D Date II tJ^ 0& 

RPZSCPXA-63496 PZ Z7 3 ppm D Time 

JBJ 

Staff Number of Samples • msi ^ 

Legend: Fl = Front Left, F2 = Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Pla) 

All qD5Si«Qt5_3re as viewed from Ihe street, facing property 

f.iled: ]i;i-.Sep-ii8 
63496 

Omah Exterior Paint North Arrwy a Lead Site 

Sit |3^oo d e Sketch • Poor 

Sampling Address: 2436 N 45 AV Q Not paint 

Sample Lead Sample Samples Collected Number LAB Concentration Collected Firm: ?£• Cc . EKT . 

RYASCPXA-63496 F1 t 2 q ppm D Date: \ 0 -IT-O g 

RYBSCPXA-63496 F2 2 2 "7 ppm D Time: 10'. i' l A 1-^. 

nYCOGPXA-63406 D Samples Analyzed RYDSCPXA-63496 B2 _l_!JL3_ppm D 

RDZSCPXA-63496 DZ 

Ct 2ft ppm D XRF Unit; (o5'^ a Book: 2ZC ) 

ROZ00rXA-6349C S3- - " ppm D Dale: II •0^0 & 

RPZSCPXA-63496 PZ 2. I 3 ppm D Time: fl^j 

Staff: mSL ^ Number of Samples = | 5 

Legend: Fl = Front Left, F2 • Front Right, B1 = Back Left, B2 = Back Right DZ = Drip Zone, GZ = Garden, PZ = Plai 

All quadrants are as viev/ed from the street, facing property 

Rfv:nri« Created: 10-SepJi8 rU47ni 01.23 
63496 

Omah csdBfior PBint NDtth ARONV a Lead ate 

H'Ws i ateSkstch 

Q Poor 

SannBna Atttans: 2438 N 45 AV • NOtpBTTIt 

: 

Sampte Nufnbsr ConcsntTHlion 

Sampte 

Colteted LAB 

Firm: 

Sampte ColtaiHl 

?fr <:.c. £-»c. RYAKa:T(A«3498 F l __L2J±. ppm D COte: I0-2.1-O8' 

RYB8CPXA«34ffi F2 22.-7 ppm D Tmw:. lo'.s-i fK-r- 'RVOOtaPXA'SMPS

RYOBCPXA.634K

ROZ8CPXA-B34n

ROgDOPKAiBMlB

 B4-

 B2 

 DZ 

 GZ " " 

in.^ 

_£LZS L 

.Ppni 

.PPiTi 

ppm 

D 

D 

D 

D 

XRF Unit: 

Date: 

Samptes AnalyzBd 

RFZSCPXA>B348B PZ 2.1 3 .PP«ii D Tlnffl: .Bt 

Numbar of Samptes-J_5_] m^u? 

Lfigand: PI = Front Left, FZ = Front R^ , Bl - fticK Left, EB = &nik R ^ OZ - Orip Zone, S Z ^^ Oanten, PZ = Pla; 

Ayquaitanlii hul l ths nsimiMty 

U 97: ' j(!*»>*5«*5<.-. 

113 

OCT 2 7 

im.. Q,oiJC B5­

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COASTA L ENVIRONHENTAL 

c ft 0 u r, INC . 

Consent for Access To Property 

RIGHT OF ENTRY TO PREMISES 

Grantor (the property owner) consents to and authorizes the United States 

Environmental Protection Agency (EPA) or its authorized representatives, collectively 

the Grantee, to enter and perform certain environmental response activities upon the 

following described premises: 

Owner's Name: He-i.+W^ ' H«»^c^*^-^^'«<*P*y*''"® P^°"«= iHol]'*^ ^ "^^ ^ ( 'A)c/ i 

Address of Property 2H3 ^ ^ ^^^A, ( y ^ 

covered by this 

Agreement: 

PURPOSE OF RESPONSE ACTIVITIES 

The EPA is requesting access to collect soil samples and remove soil that contains 

elevated concentrations of lead and may pose a health hazard. The area(s) will be 

excavated to remove contaminated soil. The removed contaminated soil will be 

replaced with clean materials and the area will be restored to its original condition. This 

work is being performed under the Omaha Lead Superfund Site remediation program. 

A representative of Coastal Environmental Group, contracted by USEPA, will contact 

the Grantor in-person to discuss the work to be performed, the Grantor will have an 

opportunity to review and approve the planned soil removal, and restoration work 

before it begins. Once the work is finished, the Grantor will be asked to review the work 

and confirm that it is complete and meets with the Grantor's approval. Upon 

completion, the Grantor will receive written documentation from EPA that the property 

has been remediated. 

ENVIRONMENTAL RESPONSE ACTIONS 

By signing this Access Agreement, the Grantor is granting the EPA, its employees, 

contractors and subcontractors the right to enter the property, at all reasonable times 

and with prior notice, for the sole purpose of performing the work. This access shall 

remain in effect until the work has been satisfactorily completed. The Grantor also 

agrees to; 

Page 1 of 2 
COASTA L \ :<J ^ 

ENVIKONHENTA L 

• *' PRO''*- CROUP , IHC . 

• Remove obstructions including boats, trailers, vehicles, playscape items, wood 

piles, dog houses, etc; 

• Remove flower bulbs or plants that the Grantor or the Grantor's tenant may wish 

to save; 

« Water and maintain replacement vegetation, including fertilizer application, as 

necessary subsequent to an initial watering period by EPA; 

• Abide by health and safety guidance provided by EPA; 

• If the property is rented, assist EPA in obtaining tenant approval for access to 

the property to perform the work. 

• Allow videotaping and/or photographing of the property. 

AGREEMENT NOT TO INTERFERE 

The Grantor agrees not to interfere or tamper with any of the work activities, or with any 

of the work done, or with the equipment used on his property, or to undertake any 

actions regarding the use of said property which would tend to endanger the health or 

welfare of the Grantees or the environment, or to allow others to use the property in 

such a manner. 

Should you have any questions about this program, please contact Coastal 

Environmental Group, at (402) 991-1199 

1I grant access to my properties 

D I do not grant access to my properties 

^-^'(zr ^ 

Signature Date Signature 

Date 

G I would like to be present during any sampling that is required. 

Page 2 of 2 
C O /U s TA L 

Restoration Agreement 

The puqrose of this agreement is to provide a mutual agreement as to conditions ofthe property prior to 

remediation activities. This will also serve as documentation for the purpose of assuring that restoration 

activities are completed to the satisfaction of the property owner and the United States Environmental 

Protection Agency (EPA). 

Property ID: ^ 3 *f<»4j 

Property Address: 2 »/^^ ^ l/^ 

Owner: Hg^Uf ^ Hf>6/ctyvV«.\i 

Phone; ^*/ ^ j Cf^ > ^Qa ? ftg>2 )7'Z'L 

U L \ 

On the attached diagram(s) indicate area(s) to excavate, surface structures and landscaping features and 

access location(s) to be used by the contractors. Indicate distances, depths, material types, etc. 

Photographically and Videographically document the existing conditions ofthe property and the basement if 

necessary. 

Items to be Removed by the Owner before Start of Remediation: 

The removal, storage, disposal, and/or return of these items is the Owner's responsibility. 

1 item: 

/(l\t ^ 4rVA^\ \ y>)cX.V^-fe, 

Item: V 

Item: 

Item: 

Items to be Removed by the Contractor During Remediation and Not Replaced 

Item: 

yfvv*^ jLc-i^^ ^ V.-,K ^ flcj-^ 

Item: 

Item: 

Item: 

Page 1of j 
COASTA L tMVlKONM f

c n o u r .

 NTAI . 

 IM C 

l^olcW

•tern: .

Kem: 

Item 

Pre-existing property area, 

that will be excavated, that 

is covered with grass. 

Number of trees > 2 inch 

trunk diameter 

Number of trees <= 2 inch 

trunk diameter 

Number of Sprinkler 

Zones, Control Valves, 

Timers, Heads, etc. 

Attach a sketcli of llie 

spiinklcf lavout. 

Number of and size of 

each garden/ flower bed 

area. 

Attach a sketch of relativi? 

sizes and locaiitMi.s. 

Agreed upon value of plant 

materials not to be 

replaced bv contractor. 

Note this \aliie will he 

used 10 issue n plant 

voucher to the propcrt> 

owner. 

Easement Area, to be 

excavated 

 , ^^\^^< 

^ ^ 

Landscape Inventory 

Quantity Unit Condition/Type/Species 

t^a 

Quadrants 

Each 

Each 

^ 

Each 

/ 

2 Each 

Square Feet 

$ ^ 

H Each ^ \c>^A-^vc^ ^e.4,u\\ 4 

Page 2 of. 1
^ ^ 

C O Af S TA L t N VIMO M riLNTAt . 

o n o u >• . IN C 

Additioinal Comments / Instructions: 

'"Dvopc^ff \ ^ bcxcjj^ O^YVVO\^V^ 

G Check the box if Owner does not want CEG to document interior foundation walls and possible 

pre-existing damage. By checking this box CEG Is not responsible for any damage done to the 

interior of house, including foundation cracks or fissures. 

IQfi agree G I do not agree 

Owner'ss Signatur Signaturee /"/ ^^ )) /l^ /i^ ee Contractor' Contractorss Signatur Slgnatur e Date

Page 3 of 2_ 
BVID# L>?MR\ ^ 

XRF PROPERTY SAMPLE SHEET 

Date 

Project 

XRFID# 

Shot# 

JiifL^ 

235i±. ZVb^ ^ 

lyiKP 

Average

Shot# 

_22>5o_ 

2-35) 

7.?»5? 

g^^ ^

Average

Shot# 

Average 

Shot# 

Average 

lab sample # 

1'?>0-D<^ Address 2M?>L^ w a^s av e 

Omaha lead FP 2nd year opilon Sample time lu :m amm 'SIO^Cl sample length 30 sec 

Reading Sample area Shol# Reading Sample area 

iMT.'^ftl iS.77 22iH5L ^23iAa^ilJ3i£ 

ISS.OIfltHtf.'M :SLL 2.-?>Mw Sg<^ .ftUl Til; 2.1 JZZ. IHTIJI ^ 32 Depth 7r3Mn HO'I PUtZH.TM Depth 

l\'5.1>qtr>.f^T Jj2_ -22^H&. ]ff?il.'\?>tJtlS^ 

 I'a,^ q 4 1 |M . 1 ^ Average <>7U,0f> 1 Z l l? i 

Reading Sample area Shot# Reading Sample area 

U^.^bUHZ-^ ,vWv^fiX^V 

t A tQ?,lnSl>^.tU? 

<^^.P1i^n.l^ Depth Depth 

 |n^.2'?j|-l7.'tW' 

 m?. q'S t 1 ^ .^ 1 Average 

Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average 

RETEST AREAS 

Reading Sample area Shot# Reading Sample area 

Depth Depth 

Average 

Lab result Sample area XRF Avg. 

Signature; £MM. p""to(^o|;ijnPM^ teeres 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2397 

Mode SOIL 

Time 2009-07-30 16:14 

Duration 121.40 

Sequence Final 

Flags 

AVERAGE i5Avg2L23a£2Sg^ 

ADDRESS 2436 N 45 ave 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

± Error 

Pb ± /C3A727 -/ 

Supervised Bv: ?I^M^I?DJ) 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 147.332 

Supervised By: 

Certificate of Verification 

2393 

SOIL 

2009-07-30 16:12 

30,17 

Final 

63496 

2436 N 45 ave 

B2 

Nicolas 

6 

CLEARANCE 

± Error 

± 15.219 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 183.064 

Supervised By: 

Certificate of Verification 

2394 

SOIL 

2009-07-30 16:13 

30.55 

Final 

63496 

2436 N 45 ave 

B2 

Nicolas 

6 

CLEARANCE 

± Error 

± 16.739 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 111.794 

Supervised By: 

Certificate of Verification 

2395 

SOIL 

2009-07-30 16:13 

30.11 

Final 

63496 

2436 N 45 ave 

B2 

Nicolas 

6 

CLEARANCE 

± Error 

± 13.381 
f 

Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2396 

Mode SOIL 

Time 2009-07-30 16:14 

Duration 30.57 

Sequence Final 

Flags 

BVID # 63496 

ADDRESS 2436 N 45 ave 

QUAD/ZONE B2 

INSPECTOR Nicolas 

DEPTH 6 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 115.587 ± 13.569 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2349 

Mode SOIL 

Time 2009-07-30 11:56 

Duration 122.01 

Sequence Final 

Flags 

AVERAGE f^^^^3A8 i 

ADDRESS ^3 6 N 45ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb [r^&:o5T~i ± ^^Z ^ 

Supervised By: /'^Ai'j P X? OZ) 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2345 

Mode SOIL 

Time 2009-07-30 11:54 

Duration 30.25 

Sequence Final 

Flags 

BVID # 63496 

ADDRESS 2436 N 45 ave 

QUAD/ZONE DZ 

INSPECTOR Nicolas 

DEPTH 13 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm Error 

Pb 523.661 ± 27.650 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 539.060 

Supervised By: 

Certificate of Verification 

2346 

SOIL 

2009-07-30 11:55 

30.56 

Final 

63496 

2436 N 45 ave 

DZ 

Nicolas 

13 

CLEARANCE 

± Error 

28.219 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 409.062 

Supervised By: 

Certificate of Verification 

2347 

SOIL 

2009-07-30 11:55 

30.58 

Final 

63496 

2436 N 45 ave 

DZ 

Nicolas 

13 

CLEARANCE 

± Error 

± 24.739 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 632.431 

Supervised By: 

Certificate of Verification 

2348 

SOIL 

2009-07-30 11:56 

30.62 

Final 

63496 

2436 N 45 ave 

DZ 

Nicolas 

13 

CLEARANCE 

± Error 

± 30.530 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Blllerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2354 

Mode SOIL 

Time 2009-07-30 11:59 

Duration 121.60 

Sequence Final 

Flags 

AVERAGE tJiil9-oL235{U2 

ADDRESS 2436 N 45 ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb [362aS— 3 ± (ZZn^SK. 

Supervised By: ^CCf/JU2eJ S 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 119.801 

Supervised By: 

Certificate of Verification 

2350 

SOIL 

2009-07-30 11:57 

30.43 

Final 

63496 

2436 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

d: Error 

± 14.234 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 100.648 

Supervised By: 

Certificate of Verification 

2351 

SOIL 

2009-07-30 11:58 

30.54 

Final 

63496 

2436 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

13.161 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

Certificate of Verification 

XL3t-32089 

Reading No 2352 

Mode SOIL 

Time 2009-07-30 11:59 

Duration 30.21 

Sequence Final 

Flags 

BVID # 63496 

ADDRESS 2436 N 45 ave 

QUAD/ZONE easement 

INSPECTOR Nicolas 

DEPTH 1 

SAMPLE TYPE CLEARANCE 

NOTE 

ppm ± Error 

Pb 98.078 db 13.143 

Supervised By: 
Thermo 

SCIENTIFI C 

Thermo Fisher Scientific 

900 Middlesex Turnpike 

Billerica, MA 01821 

XL3t-32089 

Reading No 

Mode 

Time 

Duration 

Sequence 

Flags 

BVID # 

ADDRESS 

QUAD/ZONE 

INSPECTOR 

DEPTH 

SAMPLE TYPE 

NOTE 

ppm 

Pb 93.271 

Supervised By: 

Certificate of Verification 

2353 

SOIL 

2009-07-30 11: 59 

30.42 

Final 

63496 

2436 N 45 ave 

easement 

Nicolas 

1 

CLEARANCE 

± Error 

± 12.957 
Omaha Lead Site—Fixed Price EP-R7-07-05 

•<t PRO!*? ' 

Coastal Environmental Group Inc. 

www.coa8talhazmat.com 

^J ' 

COASTAL INVmOHHINTA l 

G «0 U P, IN C 

EXECUTIVE SUMMARY: 

BVID # 63496 - (2436 N 45 AVE) 

No Issues or Concerns I I Issues/Concerns 

Detail Explanation: 

NO ISSUES PENDING. 
S»L 

EPA Property Close Out Form 

Property#: (pS^^. , Property Al 

Date/Time: ,^-, Owner's Ni 

Quads Excavated; Vf e -^Y: ^ Contractor 

Excavatio Yes No n General 

1. If necessary, were the correct quadrant(s) excavated and restored? 

2. If necessary, were the correct areas of drip zone excavated and restored? T >^ 

Grading Yes No Sod and Vegetattoa 

I. Does the grading around the perimeter ofthe house in excavated areas generally slope away 1 ^ ' from the house? 

2. Has sod been laid in all areas that were excavated? 

3. Does the sod appear to be generally healthy and growing? (Only evaluate if inspected at a 30 

day time period) 

4. Are sodded areas generally Fum and evenly graded? -iP" 

5. Are die joints between the sod strips generally tight? (Only evaluate if inspected at a 30 day l / ^ time period) 

6. Was the property graded such that water will not poo! on the property'? t ^ ^ 

7. Was damage to landscaping or plant materials avoided? u-^ 

Gates, Fences and Retaining Walls 

Ves No 

1. Do gates open and close fi-eely? (Ifapplicable) 

^ " ^ 

I. Were all gates or fences taken down during restoration activities reinstalled? (If applicable) 1?^ 

3. Was damage to gates or fences avoided? (Ifapplicable) 

4. Was damage to retaining walls avoided? (Ifapplicable) 

Foundation, Siding and Gutters 

Yes No 

1. Was damage to the siding or trim avoided? I/- " 

2. Was damage to the foiuidation avoided? "z:^" 

7. Was damage to windows avoided? 1? 

4. Was damage to windows or door screens avoided? 

5. Was damage to downspouts or downspoul extensions avoided? 

Sidewalks and Drh'cways (Concrete) 

1. Was damage to driveway surfaces avoided? "vZ 

2. Was damage to walkway surfaces avoided? 
CM'oers comments: 

Inspection notes: 

Removal and resioration aclivales complete Including ihe 30-day sod warranty: 

EPA Represenlative /OA K [J/JAKJA ^ Dale: 9U l 0 ^ 
Property Completion Agreement 

I his agreement documents the completion of remedial activities perloimed on my properly My signature 

will designate Ihat I am satisfied with the restoration of my propeily. and thai no ilcins are in queslions. 

now, or al any time in (he future, except Ihose items listed below, ifany 

Property ID: ^ ^ ^^ ^ 

Property Address: ^Z^g ^ W y^/fi/ £ 

Owner: 

Phone: ^^^.^^^ 7 

Restoration Items in Question: 

Item: N^tzb y^/^^ 5 <0P /^ef> C*^Mf^- y^^/,^ 

Item: ' 

Item: 

Item: 

Item: 

Item: 

Additional Comments: 

J>\ ' sgrcc rcsror«ljon i< complcttd, except as noteri 

[_J I rfo not «(;i;*€ retu^tinn ij completed 

yyc;? 

WHO .< aignariirf Date